RECONSTRUCTION OF THE PELVIC RING IN PATIENTS WITH TUMORS OF THE SACROILIAC JOINT
Abstract
The paper presents the experience in surgical treatment of 10 patients with tumors of the sacroiliac joint. All patients underwent reconstruction of the pelvic ring with polyaxial screws and titanium rods. The mean age of the patients was 39 years (23 to 59). There were 6 (60%) patients with chondrosarcoma, 1 (10%) with fibrosarcoma, 1 (10%) with Ewing’s sarcoma, 1 (10%) with metastasis from kidney cancer and 1 (10%) with metastasis from osteosarcoma. The mean length of surgery was 4.2 hours (3 to 6). The average volume of intraoperative blood loss was 2 800 ml (1500 to 5000 ml). Microscopically positive resection margin (R1) was revealed in 2 (20 %) patients. The median follow-up was 8.5 months (2 to 40). All patients are alive with no evidence of disease progression. Postoperative complications were observed in 4 (40 %) patients. The mean Musculoskeletal Tumor Society score at last available follow-up was 70 % (62 to 92 %).
About the Authors
V. A. Derzhavin
P.A. Gertsen Moscow Research Institute of Oncology
Russian Federation
Russian Federation
Derzhavin Vitaly Andreevich - MD, PhD, Scientific Associate, Department of Surgical Treatment for Tumors of the Central Nervous and Musculoskeletal System.
Phone:+7 263893117. E-mail: Osteosa@yandex. ru. SPIN-code: 1811-2737
V. Yu. Karpenko
P.A. Gertsen Moscow Research Institute of Oncology
Russian Federation
Russian Federation
Karpenko Vadim Yuryevich - MD, PhD, Head of the Group of Bone and Soft Tissue Tumors, Department of Surgical Treatment for Tumors of the Central Nervous and Musculoskeletal System.
Phone: +79645828152. E-mail: doctor-kv@yandex.ru
A. V. Bukharov
P.A. Gertsen Moscow Research Institute of Oncology
Russian Federation
Russian Federation
Bukharov Artem Viktorovich - MD, PhD, Senior Researcher, of the Group of Bone and Soft Tissue Tumors, Department of Surgical Treatment for Tumors of the Central Nervous and Musculoskeletal System.
Phone: +789036842241. E-mail: artembuharov@mail.ru
References
1. Tepliakov V.V., Karpenko V.U., Derzhavin V.A., Frank G.A., Bulanov A.A., Bukharov A.V., Myslevtsev I.V., Anurova O.A., Rubtsova N.A., Epifanova S.V., Vorobiov N.V., Sundui U.U., Sekhina O.V. Reconstructive surgery in treatment of patients with malignant tumors of the pelvic ring // Sarkomy kostej, mjagkih tkanej i opuholi kozhi. 2012. № 3. C. 16–28. [in Russian]
2. Aebi M. The adult scoliosis // Eur. Spine. J. 2005. Vol. 14 (10). P. 925–948.
3. Akiyama T., Clark J.C., Miki Y., Choong P.F. The non-vascularised fibular graft. A simple and successful method of reconstruction of the pelvic ring after internal hemipelvectomy // J. Bone Joint. Surg. Br. 2010. Vol. 92 (7). P. 999–1005. doi: 10.1302/0301-620X.92B7.23497.
4. Beadel G.P., McLaughlin C.E., Aljassir F., Turcotte R.E., Isler M.H., Ferguson P., Griffin A.M., Bell R.S., Wunder J.S. Iliosacral resection for primary bone tumors: is pelvic reconstruction necessary? // Clin. Orthop. Relat. Res. 2005. Vol. 438. P. 22–29.
5. Campannacci M., Cappana R. Pelvic resection: the Rizzoli institute experience // Orthop. Clin. North. Am. 1991. Vol. 22 (1). P. 65–86. 6. Chan K., Resnick D., Pathria M., Jacobson J. Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients // Skeletal. Radiol. 2001. Vol. 30 (5). P. 278–281.
6. Chang D.W., Fortin A.J., Oates S.D., Lewis V.O. Reconstruction of the pelvic ring with vascularized double-strut fibular flap following internal hemipelvectomy // Plast. Reconstr. Surg. 2008. Vol. 121 (6). P. 1993–2000. doi: 10.1097/PRS.0b013e3181706ff2.
7. Court C., Bosca L., Le Cesne A., Nordin J.Y., Missenard G. Surgical excision of bone sarcomas involving the sacroiliac joint // Clin. Orthop. 2006. Vol. 451. P. 189–194.
8. Delloye C., Cornu O., Druez V., Barbier O. Bone allografts: what they can offer and what they cannot // J. Bone Joint Surg. Br. 2007. Vol. 89 (5). P. 574–579.
9. Enneking W.F. A system of staging musculoskeletal neoplasms //Clin. Orthop. Relat. Res. 1986. Vol. 204. P. 9–24.
10. Enneking W.F., Dunham W., Gebhardt M.C., Malawar M., Pritchard D.J. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system // Clin. Orthop. Relat. Res. 1993. Vol. 286. P. 241–246.
11. Fuchs B., O’Connor M.I., Kaufman K.R., Padgett D.J., Sim F.H. Iliofemoral arthrodesis and pseudarthrosis: a long-term functional outcome evaluation // Clin. Orthop. Relat. Res. 2002. Vol. 397. P. 29–35.
12. Fuchs B., Yaszemski M.J., Sim F.H. Combined posterior pelvis and lumbar spine resection for sarcoma // Clin. Orthop. Relat. Res. 2002. Vol. 397. P. 12–18.
13. Gebert C., Wessling M., Gosheger G., Aach M., Streitbürger A., Henrichs M. P., Dirksen U., Hardes J. Pelvic reconstruction with compound osteosynthesis following hemipelvectomy // Bone Joint J. 2013. Vol. 95-B (10). P. 1410–1416. 1410-6. doi: 10.1302/0301-620X.95B10.31123.
14. Gebert С., Wessling M., Hoffmann C., Roedl R., Winkelmann W., Gosheger G., Hardes J. Hip Transposition as a Limb Salvage Procedure Following the Resection of Periacetabular Tumors // J. Surg. Oncol. 2011. Vol. 103 (3). P. 269–275. doi: 10.1002/jso.21820.
15. Harrington K.D. The use of hemipelvic allografts or autoclaved grafts for reconstruction after wide resections of malignant tumors of the pelvis // J. Bone Joint Surg. Am. 1992. Vol. 74. P. 331–341.
16. Jansen J.A., Van de Sande M.A.J., Dijkstra P.D.S. Poor Long-term Clinical Results of Saddle Prosthesis After Resection of Periacetabular Tumors // Clin. Orthop. Relat. Res. 2013. Vol. 471 (1). P. 324–331. doi: 10.1007/s11999-012-2631-x.
17. Johnson J.T. Reconstruction of the pelvic ring following tumor resection // J. Bone Joint Surg. Am. 1978. Vol. 60. P. 747–751.
18. Karakousis C.P., Vezeridis M.P. Variants of hemipelvectomy // Am. J. Surg. 1983. Vol. 145. P. 273–277.
19. Kawai A., Healey J.H., Boland P.J., Lin P.P., Huvos A.G., Meyers P.A. Prognostic factors for patients with sarcomas of the pelvic bones // Cancer. 1998. Vol. 82 (5). P. 851–859.
20. Leung P.C. Reconstruction of the pelvic ring after tumour resection // Int. Orthop. 1992. Vol. 16. P. 168–171.
21. Menendez L.R., Ahlmann E.R., Falkinstein Y., Allison D.C. Periacetabular Reconstruction with a New Endoprosthesis // Clin. Orthop. Relat. Res. 2009. Vol. 467 (11). P. 2831–2837. doi: 10.1007/s11999-009-1043-z.
22. O’Connor M.I., Sim F.H. Salvage of the limb in the treatment of malignant pelvic tumors // J. Bone Joint Surg. Am. 1989. Vol. 71. P. 481–494.
23. Ozaki T., Flege S., Kervic M. Osteosarcoma of the pelvis: Experience of the Cooperative-Osteosarcoma Study Group // J. Clin. Oncol. 2003. Vol. 21. P. 334–341.
24. Ozaki T., Hillmann A., Bettin D., Wuisman P., Winkelmann W. High complication rates with pelvic allografts: experience of 22 sarcoma resections // Acta. Orthop. Scand. 1996. Vol. 67. P. 333–338.
25. Pring M.E., Weber K.L., Unni K., Sim F.H. Chondrosarcoma of the pelvis: A review of sixty-four cases // J. Bone. Joint. Surg. 2001. Vol. 83-A (11). P. 1630–1642.
26. Sabourin M., Biau D., Babinet A., Dumaine V., Tomeno B., Anract P. Surgical management of pelvic primary bone tumors involving the sacroiliac joint // Orthop. Traumatol. Surg. Res. 2009. Vol. 95 (4). P. 284–292. doi:10.1016/j.otsr.2009.04.008.
27. Satcher Jr. R.L., O’Donnell R.J., Johnston J.O. Reconstruction of the pelvis after resection of tumors about the acetabulum // Clin. Orthop. Relat. Res. 2003. Vol. 409. P. 209–217.
28. Wirbel R.J., Schulte M., Mutschler W.E. Surgical treatment of pelvic sarcomas: Oncologic and functional outcome // Clin. Orthop. Relat. Res. 2001. Vol. 390. P. 190–205.
29. Witte D., Bernd L., Bruns J., Gosheger G., Hardes J., Hartwig E., Lehner B., Melcher I., Mutschler W., Schulte M., Tunn P.U., Wozniak W., Zahlten-Hinguranage A., Zeifang F. Limb-salvage recon- struction with MUTARS hemipelvicendoprosthesis: A prospective multi- center study // Eur. J. Surg. Oncol. 2009. Vol. 35 (12). P. 1318–1325. doi: 10.1016/j.ejso.2009.04.011.
Review
For citations:
Derzhavin V.A., Karpenko V.Yu., Bukharov A.V. RECONSTRUCTION OF THE PELVIC RING IN PATIENTS WITH TUMORS OF THE SACROILIAC JOINT. Siberian journal of oncology. 2015;1(3):38-44. (In Russ.)
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